Some say rule could force disabled from homes

Bonnie Beachley has cared for mentally retarded people in her home in Hagerstown for 10 years.

She helps them get dressed in the morning, feeds them, drives them where they need to go, and makes sure they get the proper medications, all in a family atmosphere.

"I love my clients, I really do," she said.

But Beachley says she's worried that proposed new state regulations on assisted living programs could force her to close up shop and her three clients to move into institutions or onto the street.

Beachley is part of a Washington County Department of Social Services program called Project Home Certified Adult Residential Environment (C.A.R.E.), which places more than 100 disabled and elderly people in private homes in the county.

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John Kenney, the program manager for adult services for the department, criticized the regulations in a letter to the state Department of Human Resources.

The draft regulations would place a "monumental, possibly insurmountable burden" on families putting up disabled or elderly residents in their homes under Project Home, he wrote.

"Going from no regulations to this level of total bureaucratic control with the associated paperwork and red tape will force aged and disabled citizens out of their current family-assisted homes into institutions," Kenney wrote.

"I see it putting most of our C.A.R.E. homes out of business," Kenney said Thursday.

Kenney said he's been told that changes were being made in the regulations that would make them less burdensome.

Susan Seling, the acting director of adult and family services at the state Department of Human Resources, said a working group that is writing the regulations is working closely with local departments of social services to "ensure that the regulations will not have a detrimental impact on the people that the regulations would affect."

Beachley said the draft regulations would create mounds of paperwork and harm the family atmosphere she provides. She said if homes like hers close, it will cost the the state more money in the long run while robbing the clients of a family environment.

A state official defended the regulations, but said they were "very preliminary."

"Right now, we have unlicensed providers without any training giving heavy medications," said Carol Benner, the director of licensing at the Department of Health and Mental Hygiene. "We want those unlicensed caregivers to have some training. We want them to document the medications that are given."

Nurses would have to come in every 45 days to make sure drugs are stored and administered properly, she said.

"It makes sense to require some training and documentation and oversight," she said.

The new regulations are part of an attempt to consolidate the state's regulations into a "comprehensive coordinated assisted living program," Benner said. "There are some who we felt were overregulated and life will become easier for them, and there are some providers who we felt were not regulated enough and life will become more difficult for them."

Beachley and others have written to the state to complain about the regulations.

"If you expect private home families to comply with all the state regulations, so much time and wasted energy will be spent on all those issues that the client (you so much want to protect) will be lost in the paper trail," Beachley wrote.

Beachley said she receives a little more than $1,000 a month per client.

"The current pay for this program is already at a bare minimum and if more cost and care is required, I am out of the program," wrote Willa Marquiss of Smithsburg. "I fear many clients will function at much lower levels as they will lose their identity and the security that the present home environment nurtures."

Among the regulations are requirements for staffing plans, service plans, relief personnel, training and applications for licenses. One month of proposed menus also must be approved by a registered dietician.

Kenney said those regulations are more suitable to larger institutions than to private homes, which can't afford to hire staff.

"We don't set meal times or set bed times or post rules - this is a home," said Faith Foltz, who cares for six clients in Maugansville.

Foltz said regulations that say which rooms can be used as bedrooms would have prevented two of her clients from using her home. "Who are they to say we couldn't turn our living room into a bedroom for two needy persons who would have had to be in a nursing home?"

Foltz said if some homes aren't providing proper care, the state could improve the situation by having social workers make unannounced visits.

"For five years now, I've had my clients and they've become family and now they want to change something that's working so well," Foltz said.

Seling said care providers could apply for waivers from some requirements.

An executive committee made up of state legislators will review the regulations before they go into effect, and the general public will have an opportunity to comment, Benner said. The Health Subcommittee of the state Senate Finance Committee will hold a hearing on the regulations on June 3 at 9 a.m. in the James Senate Office Building in Annapolis.

The new regulations would go into effect in October if approved, Seling said.